Candidate: The recruitment and retention of productive junior investigators is one of the more critical priorities of academic medical Institutions and the research community In general. The purpose of this Midcareer Investigator Award In Patient-Oriented Research is to provide support for Kurt Barnhart MD, MSCE, a reproductive endocrinologist and epidemiologist at the University of Pennsylvania. Dr. Barnhart is an accomplished clinical investigator with continuous NIH support since he has joined the faculty at Penn in 1996. He has also been recognized as an outstanding mentor. The candidate's immediate and long-term career goals center on his desire and intention to continue to evolve and mature as a patient-oriented researcher, teacher, and mentor. In doing so, he needs to be able to enhance and focus his efforts on conducting patient- oriented research (POR), and building a clear training and mentoring path for those interested in POR in women's health. This award will be essential to allow him to achieve these goals by protecting 50% of his time by reducing his clinical and administrative duties. He will also reduce effort on some of his funded projects while concomitantly increasing the effort of junior faculty he currently mentors. Mentoring: Dr. Barnhart will focus his mentoring on scholars enrolled in the Masters of Science in Clinical Epidemiology (MSCE) via the NIH supported T32 Reproductive Epidemiology training grant. Candidates for this program include fellows in sub-specialties in women's health, family medicine and/or pediatrics. Other mentees will include junior faculty, and fellows in Reproductive Endocrinology and Infertility. He plans to serve as primary thesis mentor for some, a research mentor for others, and will transition to become PI of the T32 training grant. Research Plan: New science proposed in this application will evaluate the short term and long term consequences of assisted reproductive technology (ART), a priory area of research for the NIH. In a series of three specific aims he will investigate the association of ART with short term perinatal morbidity and childhood development. These three aims were chosen for the ability to adequately design and conduct the study in a reasonable period of time, each with a specific hypothesis that would lead to important information. Complementary, diverse, and sophisticated research methods have been proposed to address this important research area, with focus on overcoming inherent limitations in imperfect datasets and potential bias in nonrandomized studies. SA#1 will use the national SART database to test if a fresh embryo transfer is associated with increased adverse outcome compared to frozen embryo transfer. Aim #2 is use a three arm cohort study assessing childhood development in children conceived with IVF, superovulation or without medical assistance. SA #3 will use a large administrative dataset to link mothers and children and assess for autistic spectrum disorder in true population setting. These aims are designed to advance the skills of the PI, enhance multidisciplinary research and provide optimal opportunity for mentorship. Finally these aims will likely provide evidence to be used to design larger trials, hopefully using the growing cadre of reproductive epidemiologists and POR researchers in women's health nationwide, many of whom will have been mentored by Dr Barnhart.